Dallin Cole Montierth, DDS

Primary specialty

Dental AnesthesiologyTaxonomy code 1223D0004X

License

D011139 Issued in AZ

Practice address

1400 Pelham Pkwy S
Bronx, NY 10461-1197

Phone

(718) 918-3419

Fax

(718) 918-6147

NPI assigned

Feb 1, 2021

Last updated

Feb 26, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1612137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708905600000",
    "number": "1487245577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1839 E ELMWOOD ST",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852035814",
            "telephone_number": "480-276-6472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 PELHAM PKWY S",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104611197",
            "telephone_number": "718-918-3419",
            "fax_number": "718-918-6147"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1839 E Elmwood St",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852035814",
            "country_code": "US",
            "telephone_number": "480-276-6472",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MONTIERTH",
        "first_name": "DALLIN",
        "middle_name": "COLE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-02-01",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223D0004X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Anesthesiology",
            "state": "AZ",
            "license": "D011139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leslie Montgomery
• Roselyn J Montgomery, REGISTERED NURSE
• Sarah Montgomery, MS, CCC-SLP
• Tevon Montgomery
• Waltra Montgomery
• Elilary Montilla Medrano, MD
• Montofiore Medical Center
• Lucely Montolio
• Diana Vanessa Montoya, FNP
• Jacqueline Montoya, NCMA, NCICS, MA

• Dental Anesthesiology in Bronx, NY
• Providers in Bronx, NY by specialty
• Dental Anesthesiology in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.